Wednesday, April 01, 2009

Do Not Use Dirty Needles

My neuro ICU patient is currently suffering from MRSA bacteremia and endocarditis, with mycotic aneurysms in her brain causing intracranial hemorrhages. She is an IV drug user with hepatitis C and she's 30 years old.

After seeing many patients with a history of IV drug use, a staggering proportion of patients have hepatitis C, HIV, or both. Many patients have infections from dirty needles, like my patient.

Kids, just say no to drugs. But please, do NOT INJECT DRUGS. It's possibly the worst imaginable method of ingesting substances for tons of reasons (outlined below), but it also happens to give people the quickest and most intense effect (partly because it increases bioavailability by bypassing the gut). It's impressive to me that much of the morbidity arising from IV drug use (IVDU) arises from using dirty needles...
- Hepatitis C - very common
- HIV - pretty common
- MRSA, infections, etc
- higher risk of overdose
- nerve/artery damage

Never use needles. Stay away from drugs. Can you tell that I'm venting?

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